Maurice House

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question Good. At this assessment the rating has remained Good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 79 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The registered manager ensured people’s care and treatment was effective by assessing and reviewing their health, wellbeing, care, and communication needs in partnership with them. They explained that assessments for people preparing to move into the service were promptly transferred to the electronic care planning system and used as the basis for each person’s care plan. Following admission, the care plan was reviewed after 6, 12, and 24 hours to confirm that the documentation remained accurate and relevant.

A relative told us, “The assessment and documentation filled in prior to moving in is excellent. It’s a perfect opportunity to include as much information as possible.”

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

People’s care plans were person-centred and national guidance and recognised tools were used when assessing and reviewing a person’s care needs. For example, whether a person was at risk of their skin breaking down, at risk of falling, choking or losing weight. The service had a resident of the month system which meant each person had their care plan reviewed fully to help ensure it remained up to date.

Staff had a good understanding of caring for people living with dementia. One staff member said, “We use distraction and diversion and we treat sundowning (a state of confusion and agitation that can affect people with dementia, particularly during the late afternoon and evening) as very important. The Admiral nurse (specialist dementia nurse) comes once a year and we do 2 days of block training on dementia.” A relative said, “The design is perfect and staff’s understanding of dementia is really good.” Following our inspection, management confirmed the Admiral nurse had visited the service 11 times in the last 12 months.

The registered manager and staff worked well across teams and services to support people.

There was a range of external healthcare professionals and services involved in people’s care. This included the GP, paramedic practitioner, district nurses, community nurses, podiatrist, diabetic nurses and the Parkinson’s team. This helped ensure people were receiving care from the individual most appropriate to provide advice, treatment or support. A relative told us, “We are very pleased that he is now receiving physiotherapy which is making a real difference.” Another said, “The care home have supported her in getting a dental issue resolved by engaging with dentists.”

Staff worked across the service in a cohesive way. Although the lodge did not have dedicated nurses on duty, nursing staff supported people living there when they required clinical input. A staff member said, “We had a lady who was an insulin dependent diabetic and the nurse came over every day to administer it (the insulin).”

In addition, the occupational therapist had supported and encouraged one person to join an occupational therapist led exercise group for people with Parkinson’s and where people had been prescribed antibiotics, staff shared this information during their daily morning meeting.

The registered manager and staff supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support. A relative told us, “They do their best to look after his health and mental/social needs and treat him very much as an individual.”

When changes were identified, such as unplanned weight loss action was taken to provide support for people. This included introducing fortified meals, increasing the frequency of weight monitoring, making referrals to the dietician and providing supplements to help stabilise the person’s health. In another example, staff were supporting one person to lose weight in order to achieve a healthier BMI (body mass index) and a family meeting had been arranged with the dietician to ensure this was done in a safe way, with suitable professional and experienced oversight.

Where people living with dementia struggled to sit at dining tables to eat their meals, staff offered them food and snacks whilst they were moving around. A staff member said, “We feed people as and when we get the opportunity.”

The registered manager and staff monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they fully met both clinical expectations and the expectations of people themselves. A relative told us, “The care [relative] has received has been first rate and physically he’s been in the best shape he has for some time.”

The service offered exceptional opportunities to promote people’s health, independence, and wellbeing through its on-site gym. This facility included specialist equipment to support people with mobility needs and the in-house occupational therapist worked closely with people to tailor exercise programmes to their abilities. By being able to hoist some people onto the equipment it meant anyone was able to use the facility. For those who preferred it, daily armchair exercise classes were held so no one was excluded from the benefits of physical activity.

The impact to people was positive. One person who had previously relied on a walker regained strength and progressed to using only a stick to walk. Another person living with a serious illness had such a sense of improved wellbeing that they attended the exercise sessions even on their most difficult days. A person who moved in on an end-of-life pathway had such an improvement in their health through staff input that they started to go on the trips out and started to carry out some aspects of their personal care again. For another person, moving into the service stopped the loneliness they had felt living alone. They started a daily exercise routine and were now involved in their own care.

The service encouraged community engagement to improve people’s well-being. One person who was encouraged to work with local nursery children won an award due to their contribution and input.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

Staff understood the need to assess people’s capacity to ensure any decisions made were in a person’s best interests. Where people lacked capacity for decision making, details of any power of attorney’s were recorded to ensure they were involved to advocate on the person’s behalf. Some people were on covert medicines (medicines given to them without their knowledge). In these instances capacity assessments were undertaken every 3 months to ensure that this continued to be the least restrictive option and in the person’s best interests.

Multiple capacity assessments were seen for some people which included for mobility measures, to reside at Maurice House, medicine administration and use of a sensor mat.